Provider Demographics
NPI:1639324007
Name:SINDLE, KELLY ANN (PT)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:ANN
Last Name:SINDLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1623 3RD AVE
Mailing Address - Street 2:APT. 28D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3638
Mailing Address - Country:US
Mailing Address - Phone:917-608-6542
Mailing Address - Fax:
Practice Address - Street 1:1623 3RD AVE
Practice Address - Street 2:APT. 28D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3638
Practice Address - Country:US
Practice Address - Phone:917-608-6542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01-8405-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics